Healthcare Provider Details

I. General information

NPI: 1982115663
Provider Name (Legal Business Name): KATHRYN SUE RAMIREZ LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1778 WHISTLING DR
REDDING CA
96003-4594
US

IV. Provider business mailing address

1778 WHISTLING DR
REDDING CA
96003-4594
US

V. Phone/Fax

Practice location:
  • Phone: 760-813-6262
  • Fax: 760-884-8084
Mailing address:
  • Phone: 760-813-6262
  • Fax: 760-884-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: